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Accelerating client-driven care: pilot study for a social interaction approach to knowledge translation.

https://arctichealth.org/en/permalink/ahliterature155589
Source
Can J Nurs Res. 2008 Jun;40(2):58-74
Publication Type
Article
Date
Jun-2008
Author
Carol L McWilliam
Anita Kothari
Beverly Leipert
Catherine Ward-Griffin
Dorothy Forbes
Mary Lou King
Marita Kloseck
Karen Ferguson
Abram Oudshoorn
Author Affiliation
School of Nursing, University of Western Ontario, London, Canada. cmcwill@uwo.ca
Source
Can J Nurs Res. 2008 Jun;40(2):58-74
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Adult
Consumer Participation
Diffusion of Innovation
Evidence-Based Medicine
Female
Group Processes
Health Planning Councils
Home Care Services - organization & administration
Humans
Interprofessional Relations
Middle Aged
Ontario
Pilot Projects
Abstract
This study piloted a knowledge translation (KT) intervention promoting evidence-based home care through social interaction. A total of 33 providers organized into 5 heterogeneous, geographically defined action groups participated in 5 researcher-facilitated meetings based on the participatory action model. The KT evidence reflects an empowering partnership approach to service delivery. Exploratory investigation included quantitative pre-post measurement of outcomes and qualitative description of data, presented herein. The critical reflections of the groups reveal macro-, meso-, and micro-level barriers to and facilitators of KT as well as recommendations for achieving KT. Insights gleaned from the findings have informed the evolution of the KT intervention to engage all 3 levels in addressing barriers and facilitators, with a conscious effort to transcend "push" and "pull" tendencies and enact transformative leadership. The findings suggest the merit of a more prolonged longitudinal investigation with expanded participation.
PubMed ID
18714898 View in PubMed
Less detail

Client-nurse relationships in home-based palliative care: a critical analysis of power relations.

https://arctichealth.org/en/permalink/ahliterature162277
Source
J Clin Nurs. 2007 Aug;16(8):1435-43
Publication Type
Article
Date
Aug-2007
Author
Abram Oudshoorn
Catherine Ward-Griffin
Carol McWilliam
Author Affiliation
School of Nursing, The University of Western Ontario, ON, Canada. aoudshoo@uwo.ca
Source
J Clin Nurs. 2007 Aug;16(8):1435-43
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Aged
Anthropology, Cultural
Attitude of Health Personnel
Community Health Nursing - organization & administration
Cooperative Behavior
Educational Status
Female
Home Care Services - organization & administration
Humans
Internal-External Control
Longitudinal Studies
Male
Middle Aged
Models, Psychological
Nurse's Role - psychology
Nurse-Patient Relations
Nursing Methodology Research
Ontario
Palliative Care - organization & administration - psychology
Patient Participation - methods - psychology
Power (Psychology)
Professional Autonomy
Qualitative Research
Questionnaires
Abstract
To elicit an in-depth understanding of the sources of power and how power is exercised within client-nurse relationships in home-based palliative care.
As in all social relations, power is present within client-nurse relationships. Although much research has focused on interpersonal relationships in nursing, the concept of power within the client-nurse relationship in palliative care settings has not been extensively investigated.
Applying a critical lens, secondary qualitative data analysis was conducted. Seventeen nurse and 16 client transcripts from a primary study were selected for secondary data analysis. These 33 transcripts afforded theme saturation, which allowed for both commonalities and differences to be identified. Data analysis involved analytic coding.
Study findings help make explicit the underlying power present in the context of home-based palliative care and how this power is used and potentially abused. In analysing the sources and exercise of power, the linkage between macro and micro levels of power is made explicit, as nurses functioned within a hierarchy of power. The findings suggest that educational/occupational status continues to be a source of power for nurses within the relationship. However, nurses also experience powerlessness within the home care context. For clients, being able to control one's own life is a source of power, but this power is over-shadowed by the powerlessness experienced in relationships with nurses. The exercise of power by clients and nurses creates experiences of both liberation and domination.
Nurses who are willing to reflect on and change those disempowering aspects of the client-nurse relationship, including a harmful hierarchy, will ultimately be successful in the health promotion of clients in home-based palliative care. Additionally, it should be recognized that nurses work within a specific health system context and, therefore, their practice is influenced by policies and funding models implemented at various levels of the health care system.
The insights gained through this investigation may assist nurses and other health professionals in reflecting on and improving practices and policies within home-based palliative care and within home care in general.
PubMed ID
17655531 View in PubMed
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Improving gerontology content in baccalaureate nursing education through knowledge transfer to nurse educators.

https://arctichealth.org/en/permalink/ahliterature146197
Source
Nurs Leadersh (Tor Ont). 2009;22(3):33-46
Publication Type
Article
Date
2009
Author
Lynn McCleary
Katherine McGilton
Veronique Boscart
Abram Oudshoorn
Author Affiliation
Department of Nursing, Brock University, St. Catharines, ON. Persistent high fever and systemic inflammation
Source
Nurs Leadersh (Tor Ont). 2009;22(3):33-46
Date
2009
Language
English
Publication Type
Article
Keywords
Aged
Canada
Curriculum
Education, Nursing, Baccalaureate
Education, Nursing, Continuing
Education, Nursing, Graduate
Faculty, Nursing
Geriatric Nursing - education
Humans
Inservice training
Nursing Education Research
Abstract
Across practice settings, most nursing care is provided to older adults. Yet most nurses receive limited education to care for older adults, especially those with complex needs. A Knowledge Exchange Institute for Geriatric Nursing Education brought together 31 Canadian nursing faculty members and nursing doctoral students and provided them with tools and resources to enhance teaching and curriculum in baccalaureate nursing programs. Guided by the Knowledge-to-Action Process model, participants received usable summaries of the best research evidence about care for older adults and tools to increase the likelihood of successful integration of these resources in their teaching and curriculum. Feedback from participants indicates that their personal goals and the goals of the Knowledge Exchange were met. Through a public interactive wiki, participants and others will continue the process of knowledge exchange to improve nursing education and nursing care for older persons.
PubMed ID
20057265 View in PubMed
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Negotiating relational practice patterns in palliative home care.

https://arctichealth.org/en/permalink/ahliterature121965
Source
J Palliat Care. 2012;28(2):97-104
Publication Type
Article
Date
2012
Author
Catherine Ward-Griffin
Carol McWilliam
Abram Oudshoorn
Author Affiliation
Faculty of Health Sciences, Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada. cwg@uwo.ca
Source
J Palliat Care. 2012;28(2):97-104
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
Female
Home Care Services
Humans
Interviews as Topic
Male
Negotiating
Neoplasms - therapy
Nurse's Role
Ontario
Palliative Care
Abstract
Providing palliative care in the home presents a variety of challenges for nurses and other care providers. As part of a focused ethnographic study examining client/caregiver/care-provider relationships within the socio-cultural context of home-based palliative care, this paper describes the provision of palliative care to Canadian seniors with advanced cancer from the perspective of nurses. Data were collected through in-depth interviews (n=19) with three palliative care nurses and participant observations in four households over a six-to-eight-month period. Home-based palliative care nursing was depicted in this study as a dialectical experience, revealing three relational practice patterns: making time-forfeiting time, connecting-withdrawing, and enabling-disabling. Nurses attempted to negotiate the tensions between these opposing approaches to palliative care. Study findings suggest that the sociocultural context of palliative care is not conducive to high-quality palliative care and provide several insights related to future directions for practice, policy, and research.
PubMed ID
22860382 View in PubMed
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Perspectives of women with dementia receiving care from their adult daughters.

https://arctichealth.org/en/permalink/ahliterature169455
Source
Can J Nurs Res. 2006 Mar;38(1):120-46
Publication Type
Article
Date
Mar-2006
Author
Catherine Ward-Griffin
Nancy Bol
Abram Oudshoorn
Author Affiliation
School of Nursing, University of Western Ontario, London, Canada. cwg@uwo.ca
Source
Can J Nurs Res. 2006 Mar;38(1):120-46
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Adult Children
Aged
Aged, 80 and over
Canada
Caregivers
Dementia - psychology
Female
Humans
Models, Psychological
Mother-Child Relations
Abstract
The caregiving experience within Alzheimer disease is fairly well documented. However, little research has been conducted from the perspective of the person living with dementia. The purpose of this study, part of a larger qualitative investigation of mother-daughter relationships within the care process of dementia, was to elicit the perceptions and experiences of mothers receiving care from their adult daughters. Guided by feminist and life-course perspectives, the researchers conducted in-depth, semi-structured interviews with a diverse sample of 10 community-dwelling women with mild to moderate cognitive impairment. In general, the health perceptions and experiences of the women were shaped by gender and how its meaning is constructed. While mothers reported mostly positive relationships with their daughters, cultural ideologies of individualism and familism manifested in feelings of "grateful guilt." Participants managed their contradictory experiences of receiving care from their daughters by doing care, undemanding care, determining care, and accepting care. The authors recommend changes in practice, policy, and research, with the aim of addressing relevant social determinants of health such as gender and social support, thereby promoting the health and well-being of women with dementia.
PubMed ID
16671284 View in PubMed
Less detail